At 12,000 feet, the view from Mount Whitney, Calif., was not what recent Perelman School of Medicine graduate Kevin Gardner, MD, had expected. The snow-covered vista was as lovely as everyone had said it would be. But it was the sight of a hiker collapsed at the bottom of a cliff that took his breath away.
“I was so far above him on the mountain that I couldn’t tell what condition he was in,” Gardner said.
But Gardner had to quickly get over his shock and take action. Luckily, he recently completed a wilderness and disaster medicine training course that prepared him for this exact situation.
The 14-day course, developed by Peter Sananman, MD, an assistant professor of Emergency Medicine in the Perelman School of Medicine, uses the principles of wilderness and disaster medicine to teach skills that are rarely covered in a traditional medical school curriculum but are incredibly valuable across many settings.
“I think what is really unique about our program at Penn is that it came about because the students requested it—they were the ones to recognize how important this type of training would be for their careers.”
Students spend the first week of the course developing survival skills and technical expertise including learning to treat conditions such as snake bites and hypothermia as well as how construct shelters, build fires, and create warmth using simple tools such as candles and plastic bags. Each afternoon, students are immersed into real-world circumstances that range from water rescues to mass casualty and disaster drills to public health threats, such as Ebola, to large-scale event management, such as the upcoming Democratic National Convention. During the second half of the course, students head to a New Jersey wilderness camp to complete their training. At camp, students practice various field drills and live patient scenarios that include nighttime rescues, gunshot wound triage, and other survival situations while also gaining valuable teamwork and leadership experience.
“The most important skill we teach is decision-making,” Sananman said. “It’s a balance of self-knowledge, skill, and situational awareness combined with the ability to follow a systematic approach while also being ready for the unexpected. Our goal is that by the end of the course, these lessons are stored in the muscle memory of the students.”
As Gardner climbed down the side of the mountain, he mentally played out all the possible scenarios he might encounter when he reached the bottom of the cliff — just as his wilderness training taught him to do. Gardner found 23-year-old Imran Yusuf covered in snow with a severe concussion and hypothermia. Miraculously, he didn’t have any broken bones or other obvious traumatic injuries. But Yusuf was still in need of serious medical attention.
“I don’t remember my fall very well—one minute I was trudging through the snow and the next my backpack shifted and I slipped off the edge,” Yusuf said.“I was wearing microspikes on my shoes, but in that type of icy condition, I should have been wearing crampon hiking shoes to help me grip the snow.”
With the sun rapidly setting and temperatures dropping into single digits, Gardner knew that Yusuf’s condition would only get worse if he didn’t act quickly.
Gardner replaced Yusuf’s wet clothes with his own extra set. Then, using only a garbage bag and lighter, Gardner created a warming space that helped raise Yusuf’s body temperature. Soon, he began to show signs of improvement.
“It was some real MacGyver-style medicine,” Yusuf said. “I can easily say that without his help, I don’t know how I would have survived. This experience has changed my entire approach to hiking. I will never try to take on such a serious, physical hike without the proper training, equipment, and supplies.”
It took Gardner and Yusuf almost 10 hours to walk six miles and descend 6,000 feet to reach help.
“Imran showed incredible grit and toughness in getting off the mountain,” Gardner said. “I don't think I fully let my guard down until I had Imran in a warm car and I knew he would be okay.”
Gardner, now an Emergency Department medical resident at Highland Hospital in Alameda, Calif. and Yusuf, a Sam’s Club employee and film student at Santa Monica College, went their separate ways, but it’s an experience that neither one will soon forget.
“I think the biggest lesson for me is that there is no substitute for training and preparation. In both wilderness medicine and emergency medicine, we often train and prepare for things that we rarely, if ever, encounter,” Gardner said. “Whether it's on a mountain or in a busy urban emergency room, having that training and preparation allows you to be ready for anything, no matter what you encounter.”